White-Out from a Wii: Traumatic Haemothorax Sustained Playing Nintendo™ Wii

Abstract

A case is reported of a patient who sustained a significant haemothorax while playing with a Nintendo™ Wii console.

Wii is a video game console that was released by Nintendo™ in December 2006.¹ The Wii console is a wireless controller that can be used as a hand-held pointing device and detect acceleration and orientation in three dimensions. We present a case report of a patient who sustained a significantly large haemothorax while playing with her Wii console. To our knowledge, this is the first such case in the literature.

Case report

In January 2008, a 55-year-old woman fell onto the edge of her sofa and sustained a direct closed blow to her left chest wall while playing tennis on her Nintendo™ Wii when she swung around too fast.

Three days later, she presented to her general practitioner (GP) with left-sided chest-wall pain. Her GP referred her to the local accident and emergency department for a chest radiograph. Her past medical history includes hypertension, for which she takes Ramipril and Atenolol. She was not on any anticoagulants or aspirin. She smokes 10 cigarettes a day.

On examination, she was tachypnoeic with a respiratory rate of 24 and oxygen saturation of 89% on room air. She was not tachycardic or hypotensive on presentation. Respiratory examination revealed decreased breath sounds and expansion on the left side, and dullness to percussion. The trachea was central. Heart sounds were normal. The rest of the examination was unremarkable and no other injuries were identified.

Intravenous access was obtained and a chest radiograph showed opacity in almost the entire left lung field (Fig. 1).

Figure 1.

Chest radiograph on presentation.

A chest drain was inserted and 400 ml of frank blood drained immediately, followed by 850 ml in the ensuing 45 min. The patient remained haemodynamically stable.

After transfer to a regional thoracic unit, the patient underwent video-assisted thoracoscopic evacuation of large amounts of clot from the left hemithorax. The left lung fully expanded and, having made a full and uneventful recovery, the patient was discharged home 5 days' postoperatively.

Discussion

The authors wish to highlight the severity of the injury sustained by this patient, especially when considering she was playing a computer game, which would normally be considered a sedate activity. Repetitive strain injuries have previously been reported in children playing computer games,² and there is a recent report of a child presenting with some muscular discomfort in the shoulder.³ To our knowledge, this is the first reported case of a serious injury sustained while playing with the Nintendo™ Wii console. Playing the Wii console has been shown to expend more energy than traditional computer games,⁴ and has even been advocated for use in the rehabilitation of elderly people;⁵ however, there may be some hazards to the more active game.